Individual ProviderCameron Craig LutchanskyMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address3554 Round Barn Blvd, Santa Rosa, CA 95403-0929(707) 571-3778PECOS EnrollmentBased on the most recent information from CMS, provider Cameron Craig Lutchansky does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 1:08 PM.Profile DetailsProvider ID1619590700Provider TypeIndividualFull NameLutchansky, Cameron CraigGenderMaleSole ProprietorYesEnumeration Date5/22/2020Last Updated3/28/2024Contact InformationPractice LocationPractice Address3554 Round Barn Blvd, Santa Rosa, CA 95403-0929Phone(707) 571-3778FaxUnlisted FaxMailing LocationMailing AddressPO Box 1827, Sonoma, CA 95476-1827PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseLMFT132853California